A tooth may need to be extracted from the mouth for a variety of reasons. For example, in some situations it may be desirable to extract a tooth that is decayed, damaged or loose. Other times, teeth may be extracted for ‘orthodontic’ reasons, such as to provide room for other teeth, enable other teeth to grow, etc.
In its most basic form, a tooth includes a crown, which is the upper, visible portion of the tooth, and a root structure, which is hidden from view in the boney substructure of alveolar bone comprising the socket. A tooth is secured in place by a combination of factors, including the structural relationship between the root structure and the alveolar bone of the gums and the periodontal ligaments connecting the tooth root structure to the alveolar bone.
Depending on the type of extraction, removal of a tooth may require the skills of dentists, oral surgeons, or similar professionals. As used herein, such professionals are referred to as dental professionals. The term “dental professional” should be read broadly to include any individual trained or skilled to extract teeth from a human or animal.
When a tooth includes a sufficient amount of sturdy crown to enable a dental professional to grip the tooth, the tooth may be removed by rocking the tooth until it is released from the socket. The rocking motion accomplishes at least two purposes. First, the rocking motion expands the alveolar bone in the region circumscribing the tooth socket. That rocking motion changes the structural relationship between the tooth root structure and the alveolar bone. Prior to rocking the tooth, the root structure and the alveolus are associated such that the alveolar bone provides a substantial amount of the retentive force on the tooth. The rocking motion compresses the alveolar bone surrounding the root structure, expanding the tooth socket away from the root structure.
Additionally, the rocking motion stretches the periodontal ligaments that extend from the root structure to the alveolar bone. The stretching of the ligaments may break some or all of the periodontal ligaments from the bone. In other cases, the periodontal ligaments may be stretched, but still intact, after completing the rocking motion to expand the tooth socket. In those cases, the dental professional may be able to break the tooth free from the ligaments by pulling on the tooth.
While the rocking technique allows a dental professional to remove a tooth, the procedure is not ideal. The procedure typically requires the dental professional to exert a great deal of force on the tooth to compress the alveolar bone. Additionally, the limited space in the mouth in which the dental professional must complete this rocking technique complicates the procedure. Furthermore, in some circumstances, the rocking motion can be applied with too much force damaging the crown of the tooth before the socket is sufficiently expanded or resulting in damage or breaks in the alveolar bone. If the crown is sufficiently damaged, the tooth may need to be treated as a surgical extraction to accomplish the removal. A surgical extraction traditionally required the removal of bone utilizing a rotary instrument or chisel. Further, broken alveolar bone may complicate the installation of a dental implant immediately after extraction, sometimes requiring bone grafts and subsequent implant placement at a later date.
The rocking procedure briefly described above may be difficult to perform when there is little or no crown for the dental professional to grip. For example, in some patients, the crown may be sufficiently deteriorated, or not sufficiently extended above the alveolar bone to enable a dental professional to grip the crown. In these cases, specialized tools may be used to remove bone to allow gripping of the remaining tooth structure. For example, a drill may be used to drill into the alveolar bone in the space surrounding the tooth being removed to expose more of the tooth. Drilling the bone may result in undesired bone removal. In some cases, the drilled out bone material must then be replaced with graft material and the patient must wait for the damaged alveolar bone to heal. For example, when a patient is to receive a dental implant, the patient may have to return after the tooth socket has healed to receive the implant. The pain and potential complications associated with the bone graft procedure and the delay in installation of the implant may be undesirable for both the patient and the dental professional.
Some dental professionals use manual periotomes during extraction of a tooth. Manual periotomes may be configured with a shaped tip disposed at an end of a shaft. In use, the tip may be placed at the base of the crown adjacent the periodontal ligament space. The dental professional then applies force on the shaft to force the tip into the periodontal space. A great amount of force may be required to use the manual periotome and the dental professional's hand and arm may be fatigued by the process.
As described above, a variety of special tools and techniques have been developed to improve tooth extraction. Such tools may be specialized for single purpose use. For example, in a tooth extraction and implantation procedure, separate instruments may be required to extract the tooth, collect the bone graft material, prepare the implant site and install the implant. The variety of tools may require the dental professional to be familiar with and own multiple different instruments. More than just inconvenient, the use of several different instruments may be expensive for the dental professional.